Controversies in the Anesthetic Management of Intraoperative Rupture of Intracranial Aneurysm
Despite great advancements in the management of aneurysmal subarachnoid hemorrhage (SAH), outcomes following SAH rupture have remained relatively unchanged. In addition, little data exists to guide the anesthetic management of intraoperative aneurysm rupture (IAR), though intraoperative management m...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Anesthesiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2014/595837 |
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| author | Tumul Chowdhury Andrea Petropolis Marshall Wilkinson Bernhard Schaller Nora Sandu Ronald B. Cappellani |
| author_facet | Tumul Chowdhury Andrea Petropolis Marshall Wilkinson Bernhard Schaller Nora Sandu Ronald B. Cappellani |
| author_sort | Tumul Chowdhury |
| collection | DOAJ |
| description | Despite great advancements in the management of aneurysmal subarachnoid hemorrhage (SAH), outcomes following SAH rupture have remained relatively unchanged. In addition, little data exists to guide the anesthetic management of intraoperative aneurysm rupture (IAR), though intraoperative management may have a significant effect on overall neurological outcomes. This review highlights the various controversies related to different anesthetic management related to aneurysm rupture. The first controversy relates to management of preexisting factors that affect risk of IAR. The second controversy relates to diagnostic techniques, particularly neurophysiological monitoring. The third controversy pertains to hemodynamic goals. The neuroprotective effects of various factors, including hypothermia, various anesthetic/pharmacologic agents, and burst suppression, remain poorly understood and have yet to be further elucidated. Different management strategies for IAR during aneurysmal clipping versus coiling also need further attention. |
| format | Article |
| id | doaj-art-8136f92bc3a940f7830dd710d50d31b3 |
| institution | Kabale University |
| issn | 1687-6962 1687-6970 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Anesthesiology Research and Practice |
| spelling | doaj-art-8136f92bc3a940f7830dd710d50d31b32025-02-03T06:07:22ZengWileyAnesthesiology Research and Practice1687-69621687-69702014-01-01201410.1155/2014/595837595837Controversies in the Anesthetic Management of Intraoperative Rupture of Intracranial AneurysmTumul Chowdhury0Andrea Petropolis1Marshall Wilkinson2Bernhard Schaller3Nora Sandu4Ronald B. Cappellani5Department of Anesthesia and Perioperative Medicine, 2nd Floor, Herry Medovy House, 671-William’s Avenue, Health Sciences Center, University of Manitoba, Winnipeg, MB, R3E 0Z2, CanadaDepartment of Anesthesia and Perioperative Medicine, 2nd Floor, Herry Medovy House, 671-William’s Avenue, Health Sciences Center, University of Manitoba, Winnipeg, MB, R3E 0Z2, CanadaNeurophysiology, Section Neurosurgery, Health Sciences Center, University of Manitoba, Winnipeg, MB, R3E 0Z2, CanadaUniversity of Southampton, Southampton S017 1 BJ, UKUniversity of Southampton, Southampton S017 1 BJ, UKDepartment of Anesthesia and Perioperative Medicine, 2nd Floor, Herry Medovy House, 671-William’s Avenue, Health Sciences Center, University of Manitoba, Winnipeg, MB, R3E 0Z2, CanadaDespite great advancements in the management of aneurysmal subarachnoid hemorrhage (SAH), outcomes following SAH rupture have remained relatively unchanged. In addition, little data exists to guide the anesthetic management of intraoperative aneurysm rupture (IAR), though intraoperative management may have a significant effect on overall neurological outcomes. This review highlights the various controversies related to different anesthetic management related to aneurysm rupture. The first controversy relates to management of preexisting factors that affect risk of IAR. The second controversy relates to diagnostic techniques, particularly neurophysiological monitoring. The third controversy pertains to hemodynamic goals. The neuroprotective effects of various factors, including hypothermia, various anesthetic/pharmacologic agents, and burst suppression, remain poorly understood and have yet to be further elucidated. Different management strategies for IAR during aneurysmal clipping versus coiling also need further attention.http://dx.doi.org/10.1155/2014/595837 |
| spellingShingle | Tumul Chowdhury Andrea Petropolis Marshall Wilkinson Bernhard Schaller Nora Sandu Ronald B. Cappellani Controversies in the Anesthetic Management of Intraoperative Rupture of Intracranial Aneurysm Anesthesiology Research and Practice |
| title | Controversies in the Anesthetic Management of Intraoperative Rupture of Intracranial Aneurysm |
| title_full | Controversies in the Anesthetic Management of Intraoperative Rupture of Intracranial Aneurysm |
| title_fullStr | Controversies in the Anesthetic Management of Intraoperative Rupture of Intracranial Aneurysm |
| title_full_unstemmed | Controversies in the Anesthetic Management of Intraoperative Rupture of Intracranial Aneurysm |
| title_short | Controversies in the Anesthetic Management of Intraoperative Rupture of Intracranial Aneurysm |
| title_sort | controversies in the anesthetic management of intraoperative rupture of intracranial aneurysm |
| url | http://dx.doi.org/10.1155/2014/595837 |
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